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Introduction: Guinea worm disease is caused by Dracunculus medinensis. Transmission of the disease depends on vectors (copepods). Abate applications in targeted water sources to control copepod is the main intervention. The aim of this study was to assess vector control practice in the guinea worm endemic region of Gambela, Ethiopia and to identify elimination gaps. Methodology: Retrospective analysis of routine program data recorded from 2016 to 2020 was performed. Pre-and post-copepod test is conducted on water ponds to determine the density of copepods. Based on the copepod density, the chemical is applied accordingly. The five years data was obtained from Ethiopian public health institute electronic database with permission. Results: A total of 22,131 water ponds were treated during the past five years. Out of the total treated in 2020, 4,669/7,266 (64%) were found with > 9 Copepods during pre-copepod test. 130/7,266 (1.79%) of water ponds which were post-tested after Abate application failed the requirement of scoring ≤ 9 copepods. Of the 130 water ponds, 115 (88.5%) were observed during the transmission season (April to November). Abate application trend had increased by 28.9% during the 5 years period. According to the database, some of the largest water sources found in infection reporting villages missed their 28 days regular treatment schedule. Conclusions: A single water source that has not been treated effectively could be a source of infection for both humans and animals. The practice of Abate application should be enhanced and monitored regularly. The documenting system should be improved for quality, timely information and action.

This study evaluated the effectiveness of an electronic system for managing drug-sensitive pulmonary tuberculosis patients in the Kyrgyz Republic. This was a cohort study using programmatic data. The study included patients registered on the paper-based system in 2019 and the electronic system between June 2021 and May 2022. Data was taken from 302 individuals from the electronic system for completeness and concordance in comparison with the paper-based system. The study showed that for most variables the completeness and concordance was 85.3%-93.0% and was lowest for non-mandatory fields such as medication side effects (26.8% vs 13.6%). No significant difference was observed in time taken from symptom onset to diagnosis and treatment initiation between the two systems. However, the electronic system had a significantly higher percentage of patients who initiated treatment on the same day of diagnosis (80.3% vs. 57.1%). The proportion with successful outcomes was similar in both groups, but the electronic system had a significantly lower proportion of patients with outcomes that were not evaluated or recorded (4.8% vs. 14.3%, p < 0.001). The study highlights the potential advantages of implementing an electronic TB register system for improving records. We advocate for similar studies in other regions in Kyrgyz Republic.

Introduction: Mycetoma is a chronic infection that can affect the skin, subcutaneous tissue, and bone. Although Ethiopia is in the so-called mycetoma belt, very little has been published about the disease in Ethiopia. There are no data about mycetoma in Ethiopia yet. Here, we present the first detailed description of mycetoma patients in Ethiopia. Cases presentation: Seven cases of clinically diagnosed mycetoma from Boru Meda Hospital are described. All patients presented with swelling of the foot, although sinuses and grains were identified for only one patient. Patients presented late with a median lesion duration of five years, and most had previously tried modern or traditional treatment. Differentiation between lesions of bacterial or fungal origin was not possible in our hospital, and therefore all patients were started on combined treatments of antifungals and antibiotics. Conclusions: We confirm that mycetoma is present in Ethiopia, although there is no formal reporting system. Well-designed systematic studies are warranted to determine the exact burden of mycetoma in Ethiopia. A national strategy for mycetoma disease control should be designed with a focus on reporting, diagnosis, and management.

Introduction: Timely and appropriate management of snakebites in the tropics is a lifesaver. Many snakebite patients are being bitten in remote rural areas and do not manage to get in due time to healthcare facilities. This study assessed the clinical features and the risk factors associated with treatment outcomes of snakebite patients admitted at two hospitals in the Northwest of Ethiopia. Methodology: In a retrospective cohort study, routinely collected data from 250 patients’ medical charts at University of Gondar Hospital and Metema Hospital, between September 2012 and August 2020, were reviewed. Results: The median age of the snakebite cases was 24 years (95% CI = 22-26), with 80.8% male patients. At admission 148/250 patients presented in Clinical stage 1 or 2 (local symptoms only) and 73.7% presented more than 12 hours after the bite, 80.2% received antibiotics and 79.0% antivenom. The median duration of hospitalization was 3 days (95% CI = 3-4); 72% of the patients recovered and were discharged, 10.8% died and 0.5% underwent an amputation. On logistic regression analysis, residence in rural areas (AOR = 2.52, 95 % CI = 1.2-5.3), sign of bacterial superinfection on the bite site (AOR = 4.69. 95% CI = 1.4-15.4), clinical stage 3 or 4 with systemic symptoms or toxic signs at admission (AOR = 4.84, 95% CI = 1.3-18.0) and no treatment with antivenoms (AOR = 6.65, 95% CI = 1.6-27.7) were associated with bad outcome (death, amputation and/or referred/ went against medical advice). Conclusions: Timely presentation at early clinical stage, appropriate clinical management and availability of antivenoms are cornerstones to reduce snakebite morbidity and mortality.

Most presentations of conjunctivitis are acute. Studies show that uncomplicated cases resolve within 14 days without medication. However, antibiotic prescription remains standard practice. With antimicrobial resistance becoming a public health concern, we undertook this study to assess antibiotic prescription patterns in managing acute conjunctivitis in an eye hospital in Ghana. We recorded 3708 conjunctivitis cases; 201 were entered as acute conjunctivitis in the electronic medical records (January to December 2021). Of these, 44% were males, 56% were females, 39% were under 5 years, 21% were children and adolescents (5–17 years) and 40% were adults (≥18 years). A total of 111 (55.2%) patients received antibiotics, of which 71.2% were appropriately prescribed. The use of antibiotics was more frequent in children under 17 years compared to adults (p < 0.0001). Of the prescribed antibiotics, 44% belonged to the AWaRe “Access” category (Gentamycin, Tetracycline ointment), while 56% received antibiotics in the “Watch” category (Ciprofloxacin, Tobramycin). Although most of the antibiotic prescribing were appropriate, the preponderance of use of the Watch category warrants stewardship to encompass topical antibiotics. The rational use of topical antibiotics in managing acute conjunctivitis will help prevent antimicrobial resistance, ensure effective health care delivery, and contain costs for patients and the health system.

Introduction: Schistosomiasis is one of the Neglected Tropical Diseases in Ethiopia. Since 2015, yearly school-based mass drug administration (MDA) using praziquantel has become the major control strategy. This study aimed to assess trends of Schistosoma mansoni infection in a high-endemic area in Northwest Ethiopia. Methodology: Data were extracted from routine laboratory logbooks at two health centers in West Dembia district, Amhara region, for the period 2013-2018. Wet-mount direct microscopy was used to diagnose intestinal parasites. Chi-square test was used to compare proportions of S. mansoni-positive results before and after the start of MDA with praziquantel, across sex, age groups, and seasons. Results: Data of 8002 stool tests was extracted. The proportion of S. mansoni progressively decreased from 9.6% in 2013 to 4.1% in 2018 in the overall patient population and from 20.3% in 2013 to 8.8% in 2018 in school-aged children. However, a declining trend of S. mansoni was observed before the launch of MDA and remained constant after the start of the MDA. The positivity rate was significantly higher in males and in the 5-14 years age group. S .mansoni infection in school aged children showed significant seasonal variation. Conclusions: The declined trend of S. mansoni positivity rate is encouraging and may be related to the existence of intervention packages. Although the timing of MDA was related with low positivity rate of S. mansoni infection, it has not resulted in the expected beneficial effect. Therefore, the district health office should work on both MDA and other interventions.

Introduction: Intestinal parasites have an insidious impact on human health. In response to high parasite frequencies in Northwest Ethiopia, mass drug administration (MDA) is provided for school children using albendazole/mebendazole (since 2007) and praziquantel (since 2015). The study objective was to assess trends and seasonal patterns of intestinal parasite infections in a context of MDA. Methodology: This was a descriptive study collecting routine data from laboratory registers in two health centres in Denbia district, Amhara region. Stool test results (wet-mount direct microscopy) from patients attending these centres between 2013 and 2018 were included. Frequencies of different parasite species were evaluated within and across the years and stratified by age and gender. Results: From a total of 8002 stool test results, the overall parasite frequency was 53.3%; this proportion remained constant. The most frequently diagnosed soil-transmitted helminths (STH) were Ascaris lumbricoides (16.9%) and hookworm (3.9%). STH frequency varied over the years, but was similar at the beginning (20.0%) and the end (22.0%) of the six-year period. STH infections were more frequent in winter (December-February; 20.4%) than in other seasons (16.0%). The most frequently diagnosed protozoa were Entamoeba histolytica/dispar (18.5%) and Giardia lamblia (12.2%). The frequency of Giardia steadily increased from 9.6% in 2013 to 15.3% in 2018. E. histolytica/dispar peaked in summer and G. lamblia in autumn. Conclusions: Trends in routine laboratories may be a proxy for a status quo in the community. These findings suggest that higher MDA coverages and/or interventions beyond MDA are needed to reduce intestinal parasite-related morbidity.

The need to establish and maintain good laboratory practices is recognised universally. However, due to differences in resources available for health services in different countries, allocation of financial and human resources in poor countries is severely constrained. The constraints faced by poor countries call for innovative approaches that would guarantee the minimum acceptable quality while striving to meet the highest standards. In resource-limited setting, it may be justifiable to develop and use ‘fit for purpose’ quality standards based on internationally-recognised laboratory quality management frameworks or protocols.

At present, malaria rapid diagnostic tests (RDTs) are widely available and used in parts of Asia and Latin America. In Africa, their use has been limited mainly to private health facilities. With the adoption of artemisinin combination therapies (ACTs) by most African countries as first line treatment for malaria, an effective, but expensive treatment is available, and the case for an expanded role for rapid diagnostics in the fight against malaria is clear. Despite this perceived potential role for RDTs, some challenges hinder their introduction and scale-up in the public health sector. Among the requirements are significant investments in policy development, training, infrastructure, and supply chain and quality assurance systems. African Journal of Health Sciences Vol. 14 (3-4) 2007: pp. 114-117

This synopsis seeks to highlight and promote the enormous potential that exists between these two initiatives that seek to address closely related issues and targeting the same populations at risk within a fairly well defined geographical setting. It also attempts to argue that malaria control, just like HIV-Aids control be given high priority in the New Partnership for Africa\'s Development (NEPAD) health agenda, as current statistics indicate that malaria is again on the rise. While much attention and billions of dollars have rightly been given to HIV-Aids research, treatment and prevention, malaria, and not Aids, is the region\'s leading cause of morbidity and mortality for children under the age of five years. This is the bad news. The good news is that unlike Aids, malaria treatment and prevention are relatively cheap. In addition, there is a payback to fighting malaria; support aimed directly at improving health, rather than poverty reduction, may be a more effective way of helping Africa to thrive. Robust and sustained growth may come to Africa through a mosquito net, Artemisinin-based Combination Therapies (ACTs) or a malaria vaccine, rather that a donor\'s cheque for economic development initiatives. African Journal of Health Sciences Vol. 13 (1-2) 2008: pp. 22-27

The use of synergistic drug combinations for the treatment of drug-resistant malaria is a major strategy to slow the selection and spread of Plasmodium falciparum resistant strains. In order to investigate synergistic compounds, with different modes of action, as alternative candidates for combination therapy, we used standard in vitro P. falciparum cultures and an established synergy testing method to define interactions among dapsone (DDS), atovaquone (ATQ), chlorproguanil (CPG) and its triazine metabolite chlorcycloguanil (CCG). Strong synergy was observed in the combinations DDS/CCG and ATQ/CPG. Multiple combination of these drugs, DDS/CCG/CPG/ATQ also exhibited high synergy although not higher than that of either of the two drug combinations separately. The use of this triple combination DDS/CPG/ATQ, even without an increase in synergy over their double combinations, ATQ/CPG and DDS/CCG, would contribute towards slowing the selection pressure since these drugs act against different targets and would delay the selection of parasites resistant to the three drugs, extending the useful therapeutic life of these valuable compounds.

review the programme’s scientific and technical activities. TDR’s placement within the United Nations system provides close collaboration with country offices of not only the World Health Organization but also of other co-sponsoring agencies UNICEF and UNDP, and with the World Bank. As a consequence, those who are supported by TDR often work closely with disease control programmes as well as other international organizations. Regular reviews of TDR’s research capacity strengthening programmes have helped reorient the strategy as needed, shifting focus from institutional strengthening in the 1980s to human resources strengthening in the 1990s [1], as well as identifying the need to move to a more demand-driven model of national health research systems [4]. Over the years, TDR has continued to support multidisciplinary research, particularly to bring social science research and biomedical research together through different mechanisms [6], and has reinforced this effort through training in implementation research [7] and operations research [8].